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May 9, 1990

Users and Abusers of Psychiatry: A Critical Look at Traditional Psychiatric Practice

Author Affiliations

Weston, Mass

Weston, Mass


by Lucy Johnstone, 311 pp, $45, ISBN 0-415-02839-6, paper $16.95, ISBN 0-415-02840-X, New York, NY, Routledge, 1989.

JAMA. 1990;263(18):2518-2519. doi:10.1001/jama.1990.03440180130047

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The title of this book is intriguing because of the complexity of mental health care and treatment. The author is a senior clinical psychologist in the National Health Service of England.

The book has two parts, "The Patients" and "The System," with six chapters in each. In the first she makes a strong case for understanding the psychodynamics of patients and the value of psychotherapy in treating them. Her discussions are largely focused on patients who have been hospitalized. She has made an excellent selection of patients to demonstrate psychodynamics and highlight failures of "The System." In reading this part of her book, I could not help but compare the National Health Service system that she describes with psychiatry in the United States and be thankful that I and my patients are here. I was appalled by the lack of understanding of patients and the reliance on hospitalization. She makes